Wellbeing
and the web
Tuesday January
15, 2008
One
in 10 children have mental-health difficulties. A new
online service means help is at hand.
Robert Goodman: "Our Anglo-Saxon way of life is not
child-friendly". Photograph: Frank Baron
A 10th of British children at any one time suffer
emotional, behavioural or concentration difficulties,
according to government figures. And Robert Goodman, who
masterminded the Department of Health (DoH) surveys that
produced these dramatic figures, says we should all be
appalled by them. "If it had been diabetes, it would have
been a national scandal," he says.
That's why Goodman, who is professor of brain and
behavioural medicine at King's College London Institute of
Psychiatry and the Maudsley hospital, has put "well over
£100,000" of his and his family's money into creating a
website to help those children and their families and
teachers.
Youth In Mind offers the first national directory of mental
health services available to the general public. It's a
reviewed resource bank of hundreds of books and websites.
But its biggest innovation is the chance to take online the
questionnaire that was a basic tool of the DoH surveys.
The questionnaire asks 25 to 33 questions that can be
completed in under 10 minutes by worried parents or
teachers, or by 11- to 17-year-olds themselves. Questions
like: Does your child think things out before acting? Does
he/she steal from home, school or elsewhere? Is he/she kind
and helpful? are instantly analysed in a brief report
indicating possible causes for concern.
A website cannot substitute for professional advice, but,
says Goodman: "Existing services are not very good at
getting help to all children who are in trouble, which I
consider scandalous." Worried about your child's mental
state? Click on
www.youthinmind.co.uk and you are not
alone.
Demand for such a service is soaring. Of the disturbed 10%,
half have behavioural problems, 40% anxiety or depression,
15% attention-deficit hyperactivity disorder (ADHD), and 8%
autistic spectrum disorders (some children have multiple
problems). Goodman says that behaviour is significantly
worse than 25 years ago, with "a steep social gradient in
emotional problems. Nowadays more deprived children have
more emotional difficulties."
Everyone has their pet explanation - lack of fish oil,
TV-watching, illegal drugs, lack of exercise. Likely
candidates in Goodman's eyes are widening inequality,
family breakdown, school pressures and a materialist,
consumerist society. "Not having the right trainers has
become a much worse stress."
Goodman is not afraid to oppose materialism. At his 2000
inaugural lecture his close-cropped hair was tinted pink
and blue to remind the audience to be sceptical of know-all
academics, including himself. He says: "Our Anglo-Saxon way
of life - laissez-faire, everyone for themselves - is
economically successful but not child-friendly." He is
backed up by last year's Unicef research showing that
children from Britain and the US are the least happy in the
developed world.
Poor
record
"Both behaviour and ADHD are much worse in Britain.
Norwegians live in a much more equal society, with shorter
working days, more time spent with families, particularly
on outdoor sports at weekends, public values publicly
shared. They eat lots of oily fish, too! Italy has a much
more intact family structure: people typically live
surrounded by family and lifelong friends. They enforce
social rules differently. Minor peccadilloes like running
children are tolerated. By contrast, infringements of
personal space and property are immediately sanctioned, and
not only by parents. Italians are physically and
emotionally warm, too. That pattern is pretty much exactly
what parenting programmes like ours at the Maudsley are
about."
Over the past 20 years, the Maudsley has pioneered the
scientific understanding of parenting, led by Professor
Stephen Scott; obsessive compulsive disorder (OCD), led by
Dr Isobel Heyman; and hemiplegia (a kind of cerebral palsy
affecting one in 1,000), led by Goodman himself.
Yet developing a reliable statistical tool to analyse the
needs of whole populations may turn out the most important
of all, globally. The questionnaire, in over 70 languages,
is available free from
www.sdqinfo.com for any
non-profit, non-charging organisation.
An "unglamorous" year of statistical research in 1995-96,
endlessly refining the right questions, produced the
questionnaire of one page - six times shorter than the
Child Behaviour Checklist, the previous gold-standard
survey from the US.
Over the past decade, DoH child mental-health surveys have
assessed 20,000 five- to 16-year-olds: 1,500 "looked after"
by their local authority and the rest living at home.
Parents and their 11- to 16-year-olds took part in
hour-long interviews; teachers filled in a briefer
questionnaire. All information, including transcripts of
interviewees' own words, was reviewed by child
psychologists and psychiatrists.
Such transcripts were particularly important for disorders
such as OCD, where questions are easily misinterpreted.
Asked if their son "does things over and over again even
though he knows he shouldn't", a family might say "yes".
Sounds like OCD? Well, yes, except comments in the recorded
interview might reveal that what the boy does is bounce on
the bed and kick a football inside the house.
"Doing these surveys made me realise how much unnecessary
suffering was caused by common mental-health problems,"
says Goodman. "These problems were not being treated. Yet I
knew that for many of them, there were effective
treatments." He gives as examples parent management
training for behavioural disorders and cognitive
behavioural therapy for OCD, anxiety and depression. The
DoH surveys showed that only around a quarter of those in
need got specialist help; and this was not necessarily the
right kind.
So he and his family have been working since 1999 to set up
Youth In Mind, which launches this month. His businessman
father, Jack, medical researcher daughter, Anna, history
student son, James, and art student daughter, Rosa, have
all pitched in with funding, programming, design and time.
"It's not dramatic, but it is using computers and the
internet for something they are really good at: clarifying
needs and directing people to where they can get help."
www.youthinmind.co.uk
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